Opioids have gripped Gratiot County for many years

(Editors note: This is the fourth story in a series exploring individual and community costs associated with opioid abuse and addiction.)

Although there are 12 confirmed opioid-related deaths in Gratiot County since 2013, there are actually more.

“There’s a lot more drug-related deaths in our area for that but it’s (officially determined by) the county in which they die in versus the county in which they live in,” said Kurt Anderson, Gratiot County’s medical examiner. “It’s typically from oral pain medicine such as hydrocodone. I can’t remember any direct heroin-related deaths.”

From 1999 to 2014, there were a total of 30 drug poisoning deaths related to heroin or opioids in Gratiot County, according to Michigan’s death certificates via the Division for Vital Records and Health Statistics from the Michigan Department of Health and Human Services.

Hospitals have been busy taking in patients with any mention of opiate-related diagnoses.

There were 342 total hospitalizations from 2008 to 2013, and an average during that time of 6.4 people per a population of 10,000 people.

People who start using drugs such as opioids and heroin often have some kind of trauma in their lives, according to Jennifer Morse, Medical Director for the Mid-Michigan District Health Department, Central Michigan District Health Department and District Health Department No. 10.

“As a general rule, they don’t make people high. They tend to numb people. A lot of times it is a form of self-medication,” Morse said. “They’ve found that a large number of people that use opioids have some history of physical, sexual abuse in the past and have some history of mental health history.”

Typically, opioid addiction can start from prescription pain pills taken orally, she said.

Then, the ways opioids are ingested into the body can change quickly.

“Most people who do take prescription opioids will progress and start crushing them. Often, they’ll start snorting them. Then, often they’ll inject them like you would heroin,” Morse said. “This occurs within the first five years of use.”

The death rate for opioid addicts is much higher than those who are not opioid addicts, from six to 20 times higher, Morse said.

Overdosing is the most common way people die related to opioids.

“Typically, it is accidentally taking more, or taking stronger, opioids than you intended,” Morse said. “It suppresses your breathing and heart rate to the point where you die.”

People who get out of jail or rehab that go without opioids for a period of time can start using again, which can cause an overdose.

“They start using again with the same amount they used before they went without drugs and their body can’t handle the amount,” she said.

In addition, people who overdose are often found with other drugs in their system such as alcohol and sleeping pills.

“Mixing different drugs or medicine together to cause the body to slow down is a very common cause for people to accidentally overdose,” Morse said.

A concern for Morse is the spread of infection such as HIV and hepatitis C related to drug use.

“People who snort drugs often use a straw and they share that straw and that’s a risk factor for spreading blood-borne diseases just like injecting drugs is,” Morse said.

For Anderson, who has been a practicing physician for 35 years, the concept of the “pain paradigm” has shifted.

“I think the problem that ended up was people ended up taking them not only for their physical pain but for the mental and psychological pain,” he said. “A few years ago doctors were being criticized for under-treatment of pain and now they’re being criticized for over-treatment of pain.”

Anderson said he works by the rules of his profession as best as he can.

He has what is called a “pain contract” with his patients that follow strict prescription guidelines, Anderson said.

“They don’t ask for more or use any other drugs because we drug test them,” he said.

Now that the county has entered a statewide lawsuit against opioid manufacturers and retailers that sell them, Anderson reflected on how opioid addiction has been evolved.

“We were a little more liberal back when I started in the mid-to-early 80’s with Vicodin,” he said. “Back then, the makers of Vicodin had published papers that there was no risk of abuse or misuse. They refuted that years later but the horse was out of the barn by that time.”